Provider Demographics
NPI:1104016427
Name:LESHINSKY, IRENE (MS, DO)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:LESHINSKY
Suffix:
Gender:F
Credentials:MS, DO
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:LESHCHINSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2500 MARYLAND RD
Mailing Address - Street 2:SUITE #400
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1216
Mailing Address - Country:US
Mailing Address - Phone:215-481-3064
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:STE 2B
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2222
Practice Address - Fax:215-481-4361
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019611207R00000X
PAOS015082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA394140Medicare PIN